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APP�ICATIO� FOR CONSTRUCT['�N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PIEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: $]GAS ❑ELECTRIC ❑ -� <br /> 259-8810 <br /> fR DEMOLITION ❑ COMBINATION CJ BUILD{NG LJ MECHANICAL ❑PLUMBING ❑ SI(iN <br /> XONMER M�ILAD�RE55 GITY ZIP PHONE <br /> Michael d Diane Wilton P.O. Box 5155 Lynnwood, WA 98046 206-778-2166 <br /> TEILINT MRIL p00RE55 CITV 2�P PIIONE <br /> Central Welding 2530 Hevitt Ave. Everett, WA 98201 206-259-2165 <br /> ARCHITECTORDESIGNFR MAILADDRESS CITY ZIP PMONE n,� <br /> __- —��_U'!�� <br /> kGENERQCONTRAGTOR MAILADDFE55 GITY ZIP PHONE V^TRTELi�ENSE� � <br /> � <br /> Oi1NER <br /> � MEGHIINICAICONTNACTOR MAIIpDORE55 GITV ZIP PMONE STATELICENSE� <br /> PLUMBMGCONTRALTOfi MAILAODRESS qTY 21P PHONE STATELICENSE/ <br /> � CONiRACT PRICE OF WORK <br /> DESLflIBE WOFiK/J!D SOUARE FOOTAGE INVOLVED GONTACT PERSON ANU PIKKJE NO. <br /> Demo the 2 O54 s . foot cinder block hot tar Babs Luedke 206-338-3117 or 206-259-2165 <br /> vood framed roof buildin addition and remove <br /> � concrete alab. � HEREBV CERTIFY THA7 1 HAVE READ AND EXAMINED THIS <br /> � PpOPOSED USE OF BUILDING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> � • PROVISIONS OF LAWS AND ORDINANCES OOVERNINO 7HIS TYPE OF <br /> I LEGI�LDESCRIPTIONOFPROPERTV�SHOWNBELOWORIITT�CNa�er WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> � � �oT 18 6 19 B�aK 6901/2 � TGW THAT PTN VAC q�THORITVRTOTV OLATE OR CANCE�L THE PROVISIONS OF AINY <br /> DAROTA AVE LY ADJ TO LOTS 16,17� 1.8 fi 19 OTHER STATE OR LOCAL LAW REGUUITING CONSTRUCTION OR THE <br /> � PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> 'EVERETT DIV I PLAT OF BLK 693 D-OU OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> � APPLICATION I DE AND 1 OMPLY WITH THE STATE <br /> � PARCEL TA%I.O.NUMBEN CONT9ACT0 W 18. 7 RCW AND 200 WAC. <br /> � k 4378-693-016-0000 <br /> � �pN$ipUCTqNLOANLENOER.�ODRE55.TELEP110NENUMBER <br /> } <br /> ; vnwecr�ooness 5'�""T�' /53s/ D�iE 8-24-94 <br /> } � 2 � fl! C AVE EVeiC AA 82�1 c'^°w'"Euiw�"s�"° <br /> i PLUMSINO MECHANICAL <br /> t N0. TYPE OF FlXTl1RE OFi ITEM FEE NO. TYPE OF EWIIPMEHT FEE <br /> i WATER CLOSET(TOILET) � A/CrAMNDLG UNITS-H.P. � <br /> ; BATHTUB ; FORCED AIR SYSTEMS-B.T.U. M E.A. ' <br /> � LAVATORY(WASH BASW) � UNIT HEATERS-B.LU. M � <br /> � SHOWER ' CLOTHES DRYERS ' <br /> { KITCHEN SINK 8 DISP � VENTILATION FAN � <br /> DISHWASHER � RANGE HOOD �_ <br /> j LAUNDRY TRAY ; WATER HEATER ' <br /> F CLOTHES WASHER � WOOD STOVE � <br /> � URINAL � METAL FIREPLACE(WOOD BURNING) ' <br /> I DRINKING FOUNTAIN i FIREPLACE INSERT � <br /> � FLOOR DRAIN � HEAT PUMP ' <br /> � BACKFLOW PREVENTERS � GAS PIPING � <br /> ROOF DRAINS-RAINLEADERS EXHAUST FAN <br /> �� SINK(SERVICE-BAR,ETC.) I . •� '�� <br /> i <br /> � <br /> � � <br /> � . , <br /> � �d <br /> � \ ._�, <br /> SUB TOTAL $ ; SUB TOTAL E � ' - <br /> � PERMIT S � PERMIT S � �.��' <br /> TOTAL FEE $ TOTAL FEE S ' ���,� <br /> FOR OFFlCE USE ONLY: . <br /> � FRONTSETBACK REARSETBACN SIDESETBACK PLANCHECK UMBEy�� FEE RECEIPTNO. ; <br /> 3� �'���' <br /> ' USEZONE LOTRREA v�cu+rsire FEES VALUATON FEE <br /> ❑ YES ❑ NO BUILDING � <br /> TYPEOfLONST. NO.OFSTORIES o[awNt+ NOOrVmuiMGUNrts � <br /> 6NWP PWMBING � <br /> SIZEOFBLUG. FIPESPRINKLERSREQD BpSEMENT MECHANICAL � <br /> ❑ YES C NO � <br /> OCCUPANCYLOAD FIREALARMREO'D MEIGHTLIMIiAfION <br /> ADDITIONAL PLAN CHECK � <br /> i <br /> OTHER i <br /> RE�S�N � <br /> STATE BUILDING SUHCHARGE � <br /> INTAKE9V PV.NSAPPPOVEDBY CITYOFEVERETT PUBLICWORKS i <br /> LOCAL SALES � <br /> oAT= TAX COUE IS 3105 TJTAI ; <br />